Provider Demographics
NPI:1346410768
Name:DORIN, SHIRIN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHIRIN
Middle Name:A
Last Name:DORIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 RIVERVIEW PARKWAY
Mailing Address - Street 2:A2
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071
Mailing Address - Country:US
Mailing Address - Phone:619-456-4555
Mailing Address - Fax:619-456-4777
Practice Address - Street 1:280 RIVERVIEW PARKWAY
Practice Address - Street 2:A2
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071
Practice Address - Country:US
Practice Address - Phone:619-456-4555
Practice Address - Fax:619-456-4777
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA511941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice